Organization
KLEINROCK NYSO LLC
Active
Other names
Kleinrock Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH GASKINS (DIRECTOR OF CREDENTIALING)
(972) 869-3789
Entity
Organization
Contact information
Practice address
1705 BROADWAY STE 2, HEWLETT, NY 11557-1600
(516) 593-0082
Mailing address
1705 BROADWAY STE 2, HEWLETT, NY 11557-1600
(516) 593-0082
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
06/30/2021
Last updated
06/30/2021
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